
48 Years Old. Started Heavy Periods With Clots. Found Fibroid In Uterus. Treatment To Be Done?

I clicked "done" before I was done with the letter... I wanted to add that since that last "period" ending January 1st....I hadn't had any spotting or bleeding until today almost 2 months later....my breasts have been very sore for the past week (as they used to get prior to my period coming). I also wanted to mention that I've had some discharge over the past 2 months. Sometimes it is a whitish, snotty consistancy....but most of the time clear. (Also...I HAVE had intermittent hot flashes over the past few years...nothing major)
Thanks for writing to us. I am trying to solve problem according to your concern.
Above said clinical picture represents that you are in peri-menopausal age group (48 yrs). In this age group, irregular spotting to heavy bleeding occurs in some women. It may be due to hormonal imbalance, caused by dysfunction of ovary without ovulation leads to progesterone deficiency. High FSH level (80 mIU/ ml)
represents the same.
Here, possible causes of irregular heavy bleeding are as follows:
1) Multiple small uterine fibroid (as per ultrasound).
2) Endometrial atrophy (uterine lining tissue thinned out).
3) Occurrence of Dysfunctional uterine bleeding (DUB)
Complete physical examination including pelvic/ speculum/ colposcopic exam is needed to confirm the diagnosis. Thyroid disorder & clotting factors abnormality are needed to be ruled out.
Uterine fibroid or leiomyoma is mostly a benign tumor and rarely transforms into malignant changes or leiomyosarcoma. So, you don't need to be much worried and just focus on next line of management.
In your case, treatment can be initiated with haemostatic agent combined with oral progesterone tab for 3-6 months duration.
In case of failed medical therapy, total abdominal hysterectomy (removal of uterus, tube & cervix) is the ideal choice & gold standard procedure in your age group to control bleeding & future complication completely.
After that, HRT) can be given for few years to control post menopausal symptoms (like hot flushes, vasomotor changes etc).
Clear vaginal discharge is nothing to worry if it is not associated with itching/ bad smell. Maintenance of genital hygiene is the key thing.
Here, I suggest you to consult with your gynecologist for proper guidance through medication & suggestive measures.
In the interim, the following things should help:
1) Take healthy diet with iron supplements.
2) Drink more water/ juice and eat more vegetables/ fruits.
3) Avoid heavy work or strain full activity. Keep bowel habit regular
4) Avoid stress/anxiety & maintain personal hygiene properly.
5) Wear tight breast support & take prime XXXXXXX cap to get relief from breast discomfort.
Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish your good health & take care yourself.
Regards,
Dr Soumen


Thanks for follow up query.
High FSH level is only seen near menopausal or perimenopausal stage. It indicates decreased ovarian reserve that interferes regular ovulation and leads to irregular vaginal bleeding. Co-existence of other causative factors (fibroid/ endometrial atrophy) are also associated with heavy bleeding.
Therefore, you must contact with your consulting gynecologist for next line of management and you may need to undergo abdominal hysterectomy for complete cure from current medical condition.
If you do not have any clarifications, you can close the discussion and rate the answer.
Be well and stay healthy. Just focus on next level of treatment.
Regards,
Dr Soumen

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